Community Liver Health Checks Nurse

Job responsibilities

This is a new role to support the delivery of the Surrey Liver Health Checks Operational Delivery Network (ODN) which will integrate the existing Hepatitis C ODN.

Primary liver cancer is the eighth most common cause of cancer death in the UK accounting for 3% of cancer related mortality (CRUK). Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer and presents in patients with cirrhosis. The dominant risk factors include cirrhosis caused by alcohol or viral hepatitis, and metabolic or fatty liver disease. There is a strong link with deprivation including homelessness, drug addiction, and obesity. Whilst HCC incidence is increasing in the UK (Burton JHEP reports 2021) survival remains poor with less than 15% 5-year survival.

The NHS Long Term plan https://www.longtermplan.nhs.uk/ sets out stretching targets ambitions and commitments to improve cancer outcomes and services in England over the next ten years with an ambition that by 2028 75% of cancers will be diagnosed at stage I or stage II. Liver cancer is a specific focus and represents 1/20 of the shift in early diagnosis required nationally to achieve this goal.

The Royal Surrey is one of twenty-two providers commissioned to deliver a local HCV ODN and has been selected as one of ten pilot sites for the Liver Health Checks / Cirrhosis Surveillance ODN. Funded by NHS England and Improvement the work of the HCV and Liver Cirrhosis ODNs are mutually synergistic. Initial funding for this post within the pilot is for 12 months, but the programme is anticipated to extend beyond the pilot phase as the network develops and matures.

The Primary purpose of the role is to deliver liver health assessments in primary and secondary care including GP surgeries, hospital clinics, the mobile outreach van, and static clinics within drug services. Additional responsibilities will include co-ordination of care for patients engaged in hepatocellular cancer surveillance pathways and work to improve access to care for Hepatitis C positive patients.

A background in clinical hepatology oncology or research would be an advantage but induction and training will be available for the successful appointee. Whilst this post may appeal to a nurse seeking a CNS role candidates with research and case management experience with appropriate skills will be eligible for appointment.

This is a new post required to expand Hepatology services for the effective delivery of a program of work in the Liver Health Checks pilot. Working with existing team members the post holder will deliver clinics designed to identify people with undiagnosed cirrhosis within target populations at risk for metabolic liver disease, alcohol related liver disease or people at risk of viral hepatitis.

This post has strategic and operational components and the post holder will be required to work with key stakeholders and patients across the network, to proactively support timely and rapid progression from diagnosis to cancer surveillance pathways for those identified on fibro scan assessment to have liver cirrhosis.

The successful candidate will be trained to undertake fibro scans a non-invasive diagnostic test to identify patients with advanced liver fibrosis or cirrhosis. Community based liver health checks clinics will recruit patients for assessment working closely with GPs, the HCV ODN van team, and other stakeholders. The post holder will have a key role in delivering education and health promotion advice to all patients enrolled in the program, including those with normal diagnostic investigations.

The liver health checks practitioner will co-ordinate onward referral to secondary care liver clinics and Hepatocellular cancer surveillance pathways and will work closely with the lead clinician peer support workers and pathway navigators to retain patients in cancer surveillance pathways. There will be significant overlap with the existing HCV ODN, and the post holder will also collaborate with the existing clinical nurse specialists (HCV and HBV), hepatologists and HCV ODN MDT coordinator to ensure any patient with liver disease caused by viral hepatitis can access additional diagnostics e.g., HCV diagnostics and treatment.

This is a very exciting new role to support the delivery of the Surrey Liver Health Checks ODN, which will integrate with the existing Hepatitis C ODN and the regional Hepatocellular Cancer MDT team at the Royal Surrey. Working with existing team members, including another community liver health check nurse, the post holder will deliver clinics designed to identify people with undiagnosed cirrhosis within target populations at risk for metabolic liver disease, alcohol related liver disease or people at risk of viral hepatitis.

This post has strategic and operational components and the post holder will be required to work with key stakeholders and patients across the network, to proactively support timely and rapid progression from diagnosis to cancer surveillance pathways for those identified on fibro scan assessment to have liver cirrhosis.Full training will be given in fibro scanning to ensure an ongoing comprehensive service for our patients.

Experience of substance misuse, especially alcohol would be an advantage in this role but a non-judgmental attitude is a must. The applicant must be self-motivated and organised; and treat people with compassion and empathy. A car to be able to travel to the outreach sites is also beneficial.All petrol and parking charges incurred will be refunded.

Please see the attached job description for full details the successful candidate will be required to undertake.

We welcome informal visits and chats.

Qualifications

Essential

• Experienced healthcare professional e.g. Registered nurse with current NMC PIN Qualifications or current research practitioner with extended scope of practice including patient facing activities.

Desirable

• Mentor/Teaching/Assessing qualification.
• Qualification in advanced communication skills.

Knowledge, Experience, Skills & Capabilities

Essential

• Knowledge of specialist areas relevant to this post acquired through experience in clinical settings e.g., Hepatology inpatients or outpatients, drug or alcohol services, cancer care or research.
• State the specific knowledge.
• Experience of independent practice assessing patients in a clinical area.
• CPD - Evidence of post qualifying and continuing professional development.
• Must understand the background to and aims of current healthcare policy/national guidance/CQC/ and appreciate the implications of this on engagement for this project.
• Understanding of the importance of informed consent.
• Clinical Governance and risk management.
• Working in a multi-disciplinary team environment.
• Ability to manage own caseload in accordance with Screening targets, NHS cancer targets and working across multiple sites.
• Communication skills in a variety of settings with patients, relatives, health professionals and senior colleagues and ability to dealing with conflicting/ controversial/sensitive situations.
• Excellent written communication skills including the ability to construct professional correspondence to communicate investigation results to clinical colleagues and patients.
• Phlebotomy skills (or commitment to complete relevant competencies within the induction period).
• Analytical Skills Problem-solving skills and ability to respond to sudden unexpected demands.
• Strategic thinking and forward planning an ability to anticipate and resolve problems before they arise.
• Planning Skills Demonstrated capability to plan over short-, medium- and long-term timeframes taking ownership and driving to completion.
• Ability to develop effective interpersonal relationships with colleagues across multiple working sites to improve patient experience and care.
• Communication skills, negotiation skills, influencing skills.
• Management Skills and leadership skills - Must be able to prioritise own work effectively and be able to direct activities of others.
• Strong decision-making skills and ability to liaise with other Health professionals within own scope of professional registration as underpinned by compliance with policies.
• Ability to make decisions autonomously, when required, on difficult issues, working to tight and often changing timescales.
• Ability to work autonomously across sites.
• Keep abreast of any research required for the role (best practice, latest trends or related to the post).
• Excellent IT Skills, Working knowledge of Microsoft Office with intermediate keyboard skills OR/AND any other relevant IT systems applicable to the applicant.
• Equality and Diversity Needs to have a thorough understanding of and commitment to equality of opportunity and good working relationships both in terms of day-to-day working practices, but also in relation to management systems.
• Ability to recognise barriers to communication and seek ways to effectively communicate especially when working independently.

Desirable

• Knowledge of Liver disease management including relevant diagnostic investigations.
• Understanding of Cancer Pathways relevant to liver disease surveillance and management.
• Experience of independent informed patient consent for procedures.
• Phlebotomy.

Disclosure and Barring Service Check

This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.

UK Registration

Applicants must have current UK professional registration. For further information please see NHS Careers website (opens in a new window).